Pattern of Serum ALT and AST Associated with Hepatitis E Virus (HEV) Infection among Various Populations in Plateau State, Nigeria

Aim: This study was undertaken to determine the effect of HEV on liver function enzymes. HEV is endemic in most developing countries, where the prevalence of HEV IgG antibody can be as high as 50%. Acute HEV infection is known to be a cause of decompensated liver cirrhosis. Several studies have suggested that elevated serum ALT and AST may be markers of hepatitis E virus (HEV) infection.
Study Design: Cross sectional epidemiological survey.
Place and Duration: The study was carried out in three geographical zones of Plateau State, over a six month period from July to December, 2012.
Methodology: A total of 426 human subjects were recruited for the study; categorized into 4 groups: apparently healthy (190), pregnant women (108), HIV positive patients (80), and animal handlers (48). Blood samples were collected and analyzed for HEV antibodies (IgG and IgM) using ELISA technique. HEV seropositive samples were then subjected to measurement of liver enzymes (ALT and AST), using Randox kits (Randox USA). Results obtained were analyzed using SPSS version 17.0 statistical software.
Results: Elevated ALT and AST levels of up to 1.5 folds to 3 folds above normal in seropositive subjects were found. HIV positive subjects and animal handlers recorded the highest elevated ALT level up to twice (2 folds) the upper limit of normal, (21.0±0.0 I.U/L and 19.0±0.0 I.U/L respectively), while apparently healthy subjects had the least elevated ALT level 1.5 folds the upper limit of normal (14.0±0.0 I.U/L). With regards to AST, pregnant women had the highest level of up to 3 folds of the upper limit of normal with mean of 47.7±45.5 I.U/L, followed by apparently healthy subjects with a mean of 36.2±14.2 I.U/L, but least among animal handlers that recorded a mean of 35.0±0.0 I.U/L.
Conclusion: Hepatitis E Virus infection is associated with elevated ALT & AST values. However, this association needs further evaluation by researchers.